Detrick & Kelly Chiropractic Clinic Inc

Primary specialty

ChiropractorTaxonomy code 111N00000X

License

DC007066L Issued in PA

Legal business name

DETRICK & KELLY CHIROPRACTIC CLINIC INC

Doing business as

East Otterman Chiropractic

Practice address

125 E Otterman St
Greensburg, PA 15601-2509

Phone

(724) 838-7700

Fax

(724) 838-7200

NPI assigned

Jun 6, 2006

Last updated

May 7, 2013By the provider in NPPES

Organization subpart

No

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name

Dr. Patrick Kelly Jr., DCNPI 1194703850

Title

Owner

Phone

(724) 838-7700

Specialties & licenses 1

Addresses

Other identifiers 5

Other names 1

• East Otterman Chiropractic Doing business as

Medicare fee-for-service enrollment

Enrolled in PA

Enrollment records 1

Locations

Practitioners 8

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

• Patrick J Kelly Jr., DC

  • Chiropractor
  • Greensburg, PA
  • NPI 1194703850
  Medicare reassignment NPD Authorized official
• Brian Gary Moore, DC

  • Chiropractor
  • Greensburg, PA
  • NPI 1225059876
  NPD
• Nancy Kristen Shaler, DC

  • Chiropractor
  • Greensburg, PA
  • NPI 1710904685
  NPD
• Viola A Agostino Valletta, D.C.

  • Chiropractor
  • New Kensington, PA
  • NPI 1003801531
  NPD (past)
• Domonique M Detrick, DC

  • Chiropractor
  • Greensburg, PA
  • NPI 1801872999
  NPD (past)
• Joseph Pasquino, PT

  • Physical Therapist
  • Murrysville, PA
  • NPI 1316636285
  NPD (past)
• Christina D Rife, MA, NCC

  • Mental Health Counselor
  • Greensburg, PA
  • NPI 1083182927
  NPD (past)
• Angie Speicher, D.C.

  • Chiropractor
  • Greensburg, PA
  • NPI 1639277981
  NPD (past)

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1149552000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1367884800000",
    "number": "1871532739",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "125 E OTTERMAN ST",
            "city": "GREENSBURG",
            "state": "PA",
            "postal_code": "156012509",
            "telephone_number": "724-838-7700",
            "fax_number": "724-838-7200"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "125 E OTTERMAN ST",
            "city": "GREENSBURG",
            "state": "PA",
            "postal_code": "156012509",
            "telephone_number": "724-838-7700",
            "fax_number": "724-838-7200"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "DETRICK & KELLY CHIROPRACTIC CLINIC INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-06-06",
        "last_updated": "2013-05-07",
        "status": "A",
        "authorized_official_last_name": "KELLY",
        "authorized_official_first_name": "PATRICK",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "724-838-7700",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_name_suffix": "Jr.",
        "authorized_official_credential": "DC"
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "",
            "desc": "Chiropractor",
            "state": "PA",
            "license": "DC007066L",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1813203",
            "state": "PA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUE SHIELD",
            "identifier": "427398",
            "state": "PA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "UPMC",
            "identifier": "216189",
            "state": "PA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "AETNA",
            "identifier": "5840690",
            "state": "PA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "HEALTH AMERICA",
            "identifier": "410013",
            "state": "PA"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "East Otterman Chiropractic",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Mark Desantis, PA-C
• Pamela Sue Desantis, MOTRL
• Kristen J Desarro, SLP
• Aniellio N/a Destefano, BA
• Anthony Arthur Detore, EDD
• Domonique M Detrick, DC
• Elizabeth L. Detschelt, M.D
• Shea Devine, DMD
• Hannah Ellen Devitt
• David Mark Dewitt, LMFT, LPC

• Chiropractor in Greensburg, PA
• Providers in Greensburg, PA by specialty
• Chiropractor in Pennsylvania

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 7, 2013; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.